Osteosarcoma

A Osteosarcoma describes a malignant bone tumor and is therefore also colloquial Bone cancer called. The cancer cells attack the bones and also spread in the body, especially in the lungs. If the disease is treated early, the chances of recovery are generally good.

What is an osteosarcoma?

Under the term Osteosarcoma or osteogenic sarcoma, doctors understand a malignant tumor that affects the patient's bones. Both the bone and often a nearby joint are affected and destroyed. The cancer cells travel through the bloodstream to the lungs and form metastases there.

The osteosarcoma is the most common bone tumor - around 200 people develop it in Germany every year. Males between the ages of 10 and 25 are particularly affected.

The disease usually affects the so-called long bones such as the upper arms or thighs, especially in the vicinity of the shoulder or knee joint. Osteosarcomas on the spine or skull, on the other hand, only occur in very rare cases.

causes

The exact causes for a Osteosarcoma are not yet known. Since the disease occurs particularly often during puberty, it is assumed that the increased bone activity occurring at this time is related to the osteosarcoma.

In addition to bone growth, genetic factors are very likely to play a role. Pre-existing diseases of the bones or cartilage such as Paget's disease] or osteochondroma can increase the risk of osteosarcoma. Previous cancer with additional chemotherapy or radiation therapy can also contribute to the development of an osteosarcoma.

Symptoms, ailments & signs

An osteosarcoma is mainly characterized by swelling around the affected bone. The swelling increases quickly, but is usually painless. If there is pain in the bone regardless of stress, this is a clear indication of an osteosarcoma.

Then, in addition to persistent bone pain, there is also tenderness at the point of swelling and redness. Particularly distressing symptoms are caused by bone cancer near a joint. This can lead to a very painful limitation of mobility. Since the structure of the bone is destroyed by the tumor, it can no longer adapt to everyday stress.

The affected bone therefore has a completely unstable structure. The risk of fractures is very much increased. Sudden fractures can occur even under normal, unencumbered conditions. As long as the cancer has not spread, symptoms remain local to the affected bones or neighboring joints.

After the formation of metastases in other organs, however, further symptoms occur, but these are non-specific. Among other things, fever, fatigue and a drop in performance are observed. If the cancer has not yet spread, the chances of recovery are very good, provided the tumor has been completely removed. As a rule, however, the removed bone must be replaced with an endoprosthesis.

Diagnosis & course

Is there any suspicion Osteosarcoma, the treating doctor will order an x-ray of the bones. A diagnosis can often be made based on this. In order to determine to what extent the cancer cells have already spread in the body, computed tomography and a blood test can also take place.

A tissue sample taken directly from the tumor can also confirm the diagnosis and provide information about the patient's condition. If the osteosarcoma is treated in good time, there are good chances of recovery and survival depending on the general condition and extent of the metastases. Statistically, 70% of patients survive the first 5 years after diagnosis. If there is no therapy, however, an osteosarcoma is a life-threatening disease.

Complications

Typically, osteosarcoma results in cancer of the bones. In most cases, this cancer occurs directly in the legs and arms of the patient, resulting in increased pain and restrictions in everyday life and movement for the patient. Those affected continue to look exhausted and suffer from a significantly reduced resilience.

The tumor can also spread to other regions of the body and develop cancer cells there. In most cases, this will reduce the patient's life expectancy. Complications and life-threatening conditions usually occur if the osteosarcoma is not treated. Self-healing does not occur.

The treatment of osteosarcoma is usually done with chemotherapy and a subsequent operation. There are usually no complications. The chemotherapy itself can, however, have severe side effects. Radiation therapy may also be necessary for osteosarcoma to completely defeat the cancer. In most cases, however, patients with osteosarcoma also need psychological treatment.

When should you go to the doctor?

Any swelling of the bones or restricted mobility should be presented to a doctor. If there is permanent or gradual impairment of the musculoskeletal system, there is cause for concern.Since the fastest possible diagnosis and treatment are important for the chances of recovery from an osteosarcoma, a doctor should be consulted as soon as the first irregularities appear. Otherwise, in an advanced stage of the disease, there is a risk of premature death. Ulcers, pain or impairment of joint ability should be examined and treated.

A general malaise, an unwanted decrease in body weight and a sensation of warmth in the affected areas indicate a disease that requires treatment. Fever, a decrease in exercise capacity or general performance, as well as fatigue and exhaustion are signs that should be presented to a doctor. Sensitivity disorders, numbness and hypersensitivity to touch should be clarified.

If there is internal weakness or restlessness, mood swings or indifference, a medical examination should take place. If the usual everyday processes can no longer be carried out free of symptoms and if there is an incapacity to exercise, the person concerned needs medical care. An osteosarcoma is characterized by a steady increase in symptoms and, at the same time, a gradual decrease in quality of life. A visit to the doctor is recommended at the first suspicion of a disorder.

Treatment & Therapy

The attending physician clearly has one Osteosarcoma if diagnosed, there is a high likelihood that he will order chemotherapy. This is supposed to help prevent the cancer cells from growing and spreading further in the body.

In addition, this type of treatment usually makes the tumor smaller and more accessible. This is followed by an operation to remove the tumor. If metastases already exist, these must also be surgically removed, if possible. During this procedure, healthy tissue is always removed from the immediate area in order to prevent the osteosarcoma from recurring.

The affected body part may need to be amputated; however, this is rarely the case. In most cases, another chemotherapy is necessary after the operation. If the tumor could not be completely removed, radiation therapy can also take place.

Even after healing has taken place, regular follow-up care must take place to ensure that there are no more cancer cells in the body. To this end, the lungs, among other things, are also examined in detail over a period of around five years. Only then can one speak of a complete healing in the medical sense. Whether the therapy works and the cancer can be defeated depends on the general condition of the patient and also on the stage of the disease.

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Outlook & forecast

The prognosis for an osteosarcoma essentially depends on the size of the tumor at the time of discovery, which bone was affected and whether metastases are already present in other organs. Tumors on the trunk and very extensive osteosarcomas are more difficult to treat successfully than small tumors and osteosarcomas on the extremities.

If the complete surgical removal of the tumor is possible and if aggressive chemotherapy carried out before and / or after the operation responds well, doctors assume a 5-year survival rate of 50 to 80 percent under favorable circumstances. If lung metastases also have to be removed, the chance of survival or recovery is reduced to around 40 percent. If the chemotherapy does not achieve the desired effect - that is, less than 90 percent of the tumor cells can be killed - the chance of survival in the long term also drops below 50 percent.

If the disease occurs again (relapse), the 5-year survival rate is statistically only about 25 percent; however, the actual prospect of long-term tumor-free disease depends on many factors and cannot be predicted for the individual case. Recurrences usually occur within the first two to three years after the initial diagnosis. Patients who live more than five years after the diagnosis can usually be considered cured.

prevention

As the causes of a Osteosarcoma are not clearly clarified, prevention in the strict sense is not possible. However, if symptoms such as pain, redness and swelling in the knee joint or the upper arm or thigh bone occur over a longer period of time, a doctor should be consulted as a precaution in order to rule out a possible osteosarcoma.

Aftercare

After cancer treatment, patients are by no means completely cured. There is a risk that the osteosarcoma will return and spread. Therefore, aftercare is an indispensable part of any tumor treatment. The doctor and patient usually agree on the location and scope of the follow-up care before the end of therapy.

In the first few years there is usually a quarterly examination. Then the interval is extended from appointment to appointment. From the fifth year onwards, annual follow-ups are usually sufficient. Patients should definitely keep the suggested appointments. A diagnosis in the early phase promises the best treatment success.

Rehabilitation often takes place immediately after osteosarcoma therapy. In this, the patient is prepared for reintegration in his job and his social environment. During this time, technical experts deal specifically with the complaints and promote the mobility and independence of those affected.

Subsequent medical follow-up examinations initially include a conversation in which the current condition is asked. If necessary, a physical exam will also take place. Imaging procedures such as x-rays and computed tomography are important components of the treatment of osteosarcoma. In this way, the doctor can detect a tumor in the body from the outside.

You can do that yourself

Osteosarcoma is a serious disease that requires urgent medical treatment. Nevertheless, the patient can contribute to regeneration in everyday life through self-help and improve his quality of life. This is possible through physically and psychologically oriented measures. It is generally advisable to consult the attending physician.

In the physical area, osteosarcoma and its surgery can lead to bone damage, which can be compensated for by muscle training. Stabilization through muscle training is instructed in physiotherapy and can be continued by the patient at home. A moderate amount of endurance training often restores fitness and wellbeing after therapy. Swimming and walking are particularly suitable in this context because of their joint-gentle properties.

Patients with cancer such as osteosarcoma receive mental stability in self-help groups and through psychologists and psychotherapists. Psycho-oncologists are specially trained to meet the needs of cancer patients. Conversations with relatives and friends are often helpful, although sometimes it is the social gathering that brings distraction and creates normality.

A healthy diet and adequate sleep are important for all cancer patients and therefore also for osteosarcoma. Food supplements or immunostabilizing agents may only be taken after consulting a doctor. Relaxation is provided by methods such as autogenic training, progressive muscle relaxation and yoga. This can be learned from health insurance companies, in adult education centers or in studios.